Warning Signs of Relapse

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The clinical definition of relapse is when a person is affected again by a condition that affected them in the past. By definition, for relapse to happen, the disease must have been in remission or cured. In the case of addiction, the disease is incurable (chronic), however the disease can be put into remission.

Relapse is often thought of as an event, such as taking a drink or using a drug: however relapse is actually an extended process that begins long before the use of a chemical substance. There are significant and identifiable phases of relapse.

Terrence Gorski and Merlene Miller collaborated on the development of eleven phases of relapse.

Phase 1: Internal Change
Looking good on the outside, but beginning to use unhealthy and addictive thinking to manage feelings of negative self-image. Intervene if some of the following warning signs are present: •Increased stress – can be due to a major circumstance or little things building up. •Change in thinking – working a recovery program is not as important any more. •Change in feelings – mood swings and exaggerated positive or negative feelings. •Change in behavior – not working a program like before, knowing something is wrong.

Phase 2: Denial
I begin to overlook what I am thinking and feeling, and I stop honestly telling others what I am thinking and feeling. Intervene if some of the following warning signs are present: • Worrying about myself – feeling afraid of using drugs, and dismissing the fear because the thought is too uncomfortable. • Denying that I am worried – persuading one’s self that everything is OK, when it really is not.

Phase 3: Avoidance and Defensiveness
Avoiding anyone or any situation that will force the honest evaluation of one’s thinking, feelings and changes in behaviors: and if confronted, being defensive and not listening. Intervene if some of the following warning signs are present: • Believing alcohol or drugs will never be used again – convincing one’s‐self that not much energy is needed to maintain sobriety, and keeping this though a secret. • Worrying about others – focusing more on the sobriety of others than on one’s‐self, judging other’s programs, and keeping it all a secret. • Defensiveness – avoiding discussions of personal problems for fear of being criticized or confronted. • Compulsive behavior – reverting to old, rigid and self‐defeating ways of thinking and acting. • Impulsive behavior - using poor judgment and causing problems due to impulsive behavior without thinking things through. •Avoiding people – feeling uncomfortable around others and changing behavior to be alone, making excuses not to socialize, and feeling lonely.

Phase 4: Crisis Building
Working hard to solve problems but seemingly having two new problems arise for every one solved. Intervene if some of the following warning signs are present: •Tunnel vision – focusing on one small part of life to the exclusion of everything else. •Minor depression – feeling down, sleeping too much and lacking energy without talking about the mood depression. •Loss of constructive planning – not looking ahead or thinking about what to do next. •Plan failure – plans begin to fail and each failure causes an overreaction creating new problems and feelings of guilt and remorse.

Phase 5: Immobilization
Feeling trapped in an ongoing stream of unmanageable problems and feeling unmotivated to take action. Intervene if some of the following warning signs are present: • Wishful thinking – having fantasies of escape or rescue if only a person will help or an event will happen. • Defeat – feeling like a failure, someone who cannot get anything right. • Immature wish to be happy – desire to be happy but have no idea how to make it happen or any will to make it...
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